Why is this post inappropriate?

This is a study that looked at the rate of aspiration among patients intubated in the PH (PreHospital or EMS) setting and compared them to patients intubated in the ED = (Emergency Department) setting.

There is one huge difference between these settings – EMS was not authorized to use any form of chemically assisted intubation or RSI (Rapid Sequence Induction/Intubation). At the time of this study, the only drugs available to snow the patient would have been morphine, midazolam (Versed)........ Read more »

Why is this post inappropriate?

The authors wanted to find out what method is (worst) best for ventilating patients during out-of-hospital treatment of cardiac arrest.
Endotracheal tube?
Supraglottic airway (laryngeal mask airway, laryngeal tube, and esophageal-tracheal twin-lumen airway device)?
BVM (Bag Valve Mask)?
This assumes that ventilations provide some sort of benefit to the patient. There is no evidence to support this myth.... Read more »

Why is this post inappropriate?

MV observed the following the lack of distinction in scene time for penetrating trauma mortality, which I did not give the proper attention in "EMS Time and Survival from Blunt and Penetrating Trauma." I will try to correct my mistake here.... Read more »

Why is this post inappropriate?

People will tell you that they just know the we need to load and go. Some even claim that the mythological Golden Hour is real. Maybe there will be an episode of Ancient Aliens about R Adams Cowley identifying the meaning of trauma and writing it on a cocktail napkin in a bar.
... Read more »

Why is this post inappropriate?

Is it appropriate to stop giving pain medicine just because the patient is asleep?

My little burned patient was probably not expressing relief from pain with her periods of unresponsiveness – especially since she had not received anything for her severe pain. Each time that she woke up screaming, that was also a clue. the medical command doctor’s orders were to give no pain medicine.[1]

Is propofol effective at putting patients to sleep without relieving their pain?

Why is this post inappropriate?

Digoxin (Lanoxin) is an antiarrhythmic drug, which means that it is also a proarrhythmic drug. Any drug that affects the heart’s conduction system can produced changes that are bad, good, or a combination of the two. Digoxin has been associated with a higher death rate, but is that because it is prescribed to sicker patients?... Read more »

Why is this post inappropriate?

It has been a couple of months since I wrote Part I and I have not been that motivated to write this part, but Dr. Jerome R Hoffman and Dr. Richelle J Cooper have been busy with the topic. Their paper appears in the current Emergency Medicine Australasia.

"Just before the release of the results of the third inter-national stroke trial (IST-3),1 the largest trial of thrombolysis in acute ischaemic stroke (AIS), the journal Stroke published a remarkable pre-emptive strike – a comm........ Read more »

Why is this post inappropriate?

Annals of Emergency Medicine has some Systematic Review Snapshots that are free and useful for getting a quick look at the evidence on various topics. In the current issue, there is a review of the evidence on fluid replacement for the child unable to take fluids orally, or unable to keep those fluids down.

Why is this post inappropriate?

If standard doses of nitrate – NTG, ISDN, or ISMN improve outcomes for CHF/ADHF patients, and larger IV doses are more effective than standard doses,[1],[2],[3],[4],[5],[6],[7],[8],[9],[10],[11],[12] what method(s) of drug delivery works best?

High dose IV drip?

High dose IV bolus?

A high dose IV bolus combined with a high dose IV drip?... Read more »

Why is this post inappropriate?

Dr. Minh LeCong has been a proponent of epinephrine in cardiac arrest, but he is now realizing that the evidence in favor of epinephrine is weak, old, and limited to animal studies. In humans, the evidence for epinephrine is based on an unreasonable infatuation with the temporary production of a pulse.
... Read more »

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